The stories are made up, but the problems are real.

Feb. 5th, 2017

Feb. 5th, 2017

I’m pretty sure I’m preaching to the choir with this, but the thing about preaching to the choir is that sometimes you get at an angle of analysis the choir hasn’t been using. I have heard a lot of “depriving people of health care is bad” arguments that are absolutely true, but not a lot of the following.

So let’s talk about preexisting conditions.

You know those commercials that tell you to tell your doctor if you’re suffering from dropsy, the vapors, or a dozen other conditions that make you think, “Shouldn’t my doctor know that already”? Under the current system, where people can’t be dropped from all insurance possibilities based on a preexisting condition, those notifications are necessary because record-keeping and institutional memory are imperfect. Your doctor should know that already, but they may now, so: probably mention it, huh.

But if you can be dropped based on a preexisting condition, it takes on a whole new meaning. “Tell your doctor if you have a history of respiratory infections”: right, so your doctor can write down “history of respiratory infections” in the course of figuring out what drug to give you for something different, and boom, there you are with that tag on you, and who knows what the consequences will be. Your doctor needs to know this stuff to figure out how to treat you–sometimes to figure out a subtle cause or contributing factor to what you have right now–but you suddenly have incentive not to tell them. Healthy as an ox, me, just this sprained ankle to deal with! Something very temporary! Oh please don’t tell them I have anything non-temporary. Please ignore the anemia. Do not test my thyroid. Forget the anxiety. I just won’t get treated for the life-altering allergies. Only deal with the condition I tell you I’m in here for. For heaven’s sake don’t run any tests because you caught a murmur listening to my heart or my blood pressure is behaving funny. That’s all the sprained ankle. Has to be. And let’s wait until whatever else there is has caused permanent damage, because that’s the point at which it’s too bad to ignore.

I’m not saying this hasn’t happened under the current system. It does. Of course it does. We should be moving away from it, not towards more.

And this is all bad enough when we’re talking about a heart condition, or depression, or, well, any of a number of things. But when we’re talking about something contagious, all of a sudden it’s more than a dangerous calculation for one person–it’s a dangerous calculation for the people around them, too. Is what you have bad enough to disclose and get treatment, or should you just cope with it and keep passing it along to others? I should not have to say that this is not a good system. This attitude often gets billed as “be a smart consumer of health care,” but in this case a stingy consumer of health care is the opposite of a smart one.

But that’s not the only thing pushing people toward dangerous medical dishonesty in the current political climate. There are lawsuits wending their way through the courts claiming that doctors should not have to treat people who have certain sexual orientations. So not only the questions that pertain to your sexual health but also the ones about the rest of your life health–“Do you feel safe in your relationships?” is one of my favorites–are now extremely dangerous. Not just for getting dumped from insurance, although let’s not underestimate the impact of that. But for being rejected for emergency treatment even if you pay the entire gigantic bill out of pocket.

Last week a family member made a Facebook post of a meme saying that while other people freaked out in favor of or against Donald Trump, he was just going to keep doing what he always did. The people who connect me to that family member each have quite large preexisting conditions that can no longer be hidden–one of them was treated on an emergent basis, both of them are in the records. And of course there’s me and my giant flashing neon sign that reads “preexisting condition.” So…”keep doing what I always do” is not actually a functional mode here for his own family. It’s certainly not a functional mode for the country.